Establishing diagnosis of pulmonary malignant lymphoma by gene rearrangement analysis of lymphocytes in bronchoalveolar lavage fluid

Tomoko Betsuyaku, M. Munakata, E. Yamaguchi, S. Ohe, N. Hizawa, N. Sukoh, K. Yamashiro, C. Mikuni, Y. Kawakami

Research output: Contribution to journalArticle

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Abstract

We report the successful application of gene rearrangement analysis to the lymphocytes obtained by bronchoalveolar lavage (BAL) for the diagnosis of pulmonary malignant lymphoma. A 45-yr-old female patient who had been suffering from back pain was shown to have macroglobulinemia and pulmonary infiltrative shadow by chest radiography. Transbronchial lung biopsy revealed a small B-cell infiltrate with monotypic immunoglobulin expression (IgM/κ light chain), and malignant lymphoma was highly suspected. BAL was performed to evaluate the cell profiles. The phenotyping of lavaged lymphocytes by flow cytometry revealed that the major component of the lymphocytes was CD3- positive T cells, and that CD21-positive B cells accounted for only 10% of all lymphocytes. This result was contradictory to the immunohistochemical population of lymphocytes in biopsied specimens. However, gene analysis of lavaged lymphocytes revealed positive immunoglobulin heavy chain rearrangement and negative immunoglobulin light chain and T-cell receptor rearrangement, suggesting that B cells making up a minor population of lavaged lymphocytes were proliferating monoclonally. Thus, in this case, gene analysis was an effective procedure for detecting the origin of tumor cells and distinguishing monoclonality from reactive accumulations. To our knowledge, this case represents the first reported application of gene rearrangement analysis to cells obtained by BAL. The sensitivity and usefulness of this analysis for the accurate evaluation of pulmonary lymphoproliferative lesions, when applied to BAL cells, should be emphasized.

Original languageEnglish
Pages (from-to)526-529
Number of pages4
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume149
Issue number2 I
Publication statusPublished - 1994
Externally publishedYes

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Gene Rearrangement
Bronchoalveolar Lavage Fluid
Lymphoma
Bronchoalveolar Lavage
Lymphocytes
Lung
B-Lymphocytes
Immunoglobulin Light Chains
Waldenstrom Macroglobulinemia
Immunophenotyping
Immunoglobulin Heavy Chains
Back Pain
T-Cell Antigen Receptor
Radiography
Population
Genes
Immunoglobulin M
Immunoglobulins
Flow Cytometry
Thorax

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Establishing diagnosis of pulmonary malignant lymphoma by gene rearrangement analysis of lymphocytes in bronchoalveolar lavage fluid. / Betsuyaku, Tomoko; Munakata, M.; Yamaguchi, E.; Ohe, S.; Hizawa, N.; Sukoh, N.; Yamashiro, K.; Mikuni, C.; Kawakami, Y.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 149, No. 2 I, 1994, p. 526-529.

Research output: Contribution to journalArticle

Betsuyaku, T, Munakata, M, Yamaguchi, E, Ohe, S, Hizawa, N, Sukoh, N, Yamashiro, K, Mikuni, C & Kawakami, Y 1994, 'Establishing diagnosis of pulmonary malignant lymphoma by gene rearrangement analysis of lymphocytes in bronchoalveolar lavage fluid', American Journal of Respiratory and Critical Care Medicine, vol. 149, no. 2 I, pp. 526-529.
Betsuyaku, Tomoko ; Munakata, M. ; Yamaguchi, E. ; Ohe, S. ; Hizawa, N. ; Sukoh, N. ; Yamashiro, K. ; Mikuni, C. ; Kawakami, Y. / Establishing diagnosis of pulmonary malignant lymphoma by gene rearrangement analysis of lymphocytes in bronchoalveolar lavage fluid. In: American Journal of Respiratory and Critical Care Medicine. 1994 ; Vol. 149, No. 2 I. pp. 526-529.
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